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Omha 104  Form

Omha 104 Form

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Instructions and help about hearing alj request

you or someone you know has been denied services under a medicare advantage plan is there anything that could be done well today i want to go over the appeals process with you and if you don't know who i am my name's phil mcgee i'm a physical therapist who's board certified in geriatrics and i work full time in utilization review i know first hand as both a clinician and as someone working in utilization review there are a lot of complexities to going through the appeals process and it can be confusing and overwhelming and my goal is for both members and clinicians to better understand the process of appealing a denial now i'll first start with the story this is the first time that i ever went through the appeals process with a member and i had actually been a physical therapist for 13 years and i was working in home health and this member had a medicare advantage plan after evaluating them i requested 12 visits after the third visit i found out

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